A randomised trial of re-feeding gastric residuals in preterm infants.

Academic Article

Abstract

  • OBJECTIVE: To determine whether re-feeding of gastric residual volumes reduces the time needed to achieve full enteral feeding in preterm infants. DESIGN: Parallel-group randomised controlled trial with a 1:1 allocation ratio. SETTING: Regional referral neonatal intensive care unit. PATIENTS: 72 infants of gestational age 23(0/7) to 28(6/7) weeks receiving minimal enteral nutrition (<24 mL/kg/day) during the first week after birth. INTERVENTIONS: Infants were randomised to either be re-fed with gastric residual volumes (Re-feeding group) or receive fresh formula/human milk (Fresh-feeding group) whenever large gastric residual volumes were noted. MAIN OUTCOME MEASURE: The primary efficacy end point was time to achieve full enteral feeding (≥120 mL/kg/day) after randomisation. RESULTS: The mean time to full enteral feeding was 10.0 days in the Re-feeding group and 11.3 days in the Fresh-feeding group (mean difference favouring re-feeding: -1.3 days; 95% CI -2.9 to 0.3; p=0.11). The composite safety end point of spontaneous intestinal perforation, surgical necrotising enterocolitis, or death occurred in 6 of 36 infants (17%) in the Re-feeding group versus 10 of 36 infants (28%) in the Fresh-feeding group (p=0.26). CONCLUSIONS: Re-feeding gastric residual volumes in extremely preterm infants does not reduce time to achieve full enteral feeding. This trial suggests that re-feeding might be as safe as fresh feeding, but further research is needed, due to lack of sufficient statistical power in this study for safety analysis. TRIAL REGISTRATION NUMBER: NCT01420263NCT01420263.
  • Keywords

  • Infant Feeding, Neonatology, Enteral Nutrition, Enterocolitis, Necrotizing, Female, Gastrointestinal Contents, Humans, Infant, Infant Formula, Infant, Extremely Premature, Infant, Newborn, Intestinal Perforation, Male, Milk, Human, Perinatal Death, Risk Factors
  • Digital Object Identifier (doi)

    Author List

  • Salas AA; Cuna A; Bhat R; McGwin G; Carlo WA; Ambalavanan N
  • Start Page

  • F224
  • End Page

  • F228
  • Volume

  • 100
  • Issue

  • 3